Schwarzenbacher Luca, Wassermann Lorenz, Rezar-Dreindl Sandra, Reiter Gregor S, Schmidt-Erfurth Ursula, Stifter Eva
Department of Ophthalmology and Optometry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Laboratory for Ophthalmic Image Analysis, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
J Clin Med. 2024 Aug 15;13(16):4810. doi: 10.3390/jcm13164810.
This study aims to provide a comprehensive analysis of ocular biometric parameters in pediatric patients with cataracts to optimize surgical outcomes. By evaluating various biometric data, we seek to enhance the decision-making process for intraocular lens (IOL) placement, particularly with advanced technologies like femtosecond lasers. This retrospective comparative study included pediatric patients with cataracts who underwent ocular biometric measurements and cataract extraction with anterior vitrectomy at the Medical University of Vienna between January 2019 and December 2021. Parameters measured included corneal diameter (CD), axial length (AL), corneal thickness (CT) and flat and steep keratometry (Kf and Ks). The study explored the correlations between these parameters and IOL placement. A total of 136 eyes from 68 pediatric patients were included in the study. Significant positive correlations were found between corneal diameter, age and AL. The mean CD was 11.4 mm, mean AL was 19.5 mm, CT was 581.2 ± 51.8 µm, Kf was 7.76 ± 0.55 mm and Ks 7.41 ± 0.59 mm, respectively. Older pediatric patients with larger corneal diameters and longer ALs were more likely to receive in-the-bag IOL implantation. Conversely, younger patients often required alternative IOL placements or remained aphakic. Our data indicated that over 95% of the study population and all patients aged one year and older had a corneal diameter of 10 mm or larger. Detailed ocular biometric analysis is crucial for optimizing both surgical outcomes and postoperative care in pediatric cataract patients. The positive correlations between CD, age and AL underline the importance of individualized surgical planning tailored to each patient's unique anatomical features. Additionally, our findings suggest that the use of a femtosecond laser is both feasible and safe for pediatric patients aged one year and older, potentially offering enhanced surgical precision and improved outcomes.
本研究旨在对小儿白内障患者的眼部生物测量参数进行全面分析，以优化手术效果。通过评估各种生物测量数据，我们力求改进人工晶状体（IOL）植入的决策过程，尤其是在使用飞秒激光等先进技术时。这项回顾性比较研究纳入了2019年1月至2021年12月期间在维也纳医科大学接受眼部生物测量和白内障摘除联合前部玻璃体切除术的小儿白内障患者。测量的参数包括角膜直径（CD）、眼轴长度（AL）、角膜厚度（CT）以及平坦和陡峭角膜曲率（Kf和Ks）。该研究探讨了这些参数与IOL植入之间的相关性。共有68名小儿患者的136只眼纳入本研究。发现角膜直径、年龄和AL之间存在显著正相关。平均CD为11.4mm，平均AL为19.5mm，CT为581.2±51.8µm，Kf为7.76±0.55mm，Ks为7.41±0.59mm。角膜直径较大且AL较长的年长小儿患者更有可能接受囊袋内IOL植入。相反，年轻患者通常需要其他IOL植入方式或保持无晶状体状态。我们的数据表明，超过95%的研究人群以及所有一岁及以上的患者角膜直径为10mm或更大。详细的眼部生物测量分析对于优化小儿白内障患者的手术效果和术后护理至关重要。CD、年龄和AL之间的正相关强调了根据每个患者独特的解剖特征进行个性化手术规划的重要性。此外，我们的研究结果表明，对于一岁及以上的小儿患者，使用飞秒激光是可行且安全的，可能会提高手术精度并改善手术效果。
